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P-4 Reduction of lethal means to self harm

Objective

To reduce access to lethal means of self harm

Action

Palo Alto City Manager’s Office is taking the lead: Security Personnel on the Tracks: The Palo Alto Police Department has retained a private security firm to be on site 7 days a week for the hours the Caltrain passenger line runs. The objective is to continue this staffing at least through the end of the school year. The Police Department will continue to provide increased patrols by officers along the rail line. The City is accepting donations to support this effort. If you would like to make a tax deductible donation please send a check payable to the City of Palo Alto to the address below or click on the "Donate" button to make your donation online. Please note that PayPal retains a small portion of the donation as a transaction fee. If you would like to avoid this, please use the donate by check option.

Support of Volunteers: A dedicated group of volunteers in support of this strategy are supplementing the private security guard effort. The Palo Alto Police Department will train all volunteers and provide some equipment. If you would like to volunteer please email Caroline Camhy at TrackWatch Volunteer Coordinator

Lighting: City of Palo Alto Utilities has increased the wattage of pre-existing street lighting in the area and installed new light fixtures. Discussions on more permanent and extensive lighting are underway with Caltrain.

Working with Experts in reducing Access to Self-Harm: We have been working closely with Lucile Packard Childrens Hospital and Palo Alto Medical Foundation and have spoken with national experts in this area, most recently from Harvard University. While none of our actions individually or collectively can eliminate all access, we were assured that we are doing and exploring the right steps.

Police Department is also evaluating technologies such as cameras and sensors.

Removing or restricting access to lethal means of self harm is an effective suicide prevention strategy that can decrease suicide.

Rationale and Efficacy

Increased public awareness of the role of trains in youth suicides can save young lives.

Education on the restriction of access to lethal means is seen as one of the most promising and economical strategies for preventing youth suicide. Removing or restricting access is an effective suicide prevention strategy that can decrease suicide.

Three mechanisms are hypothesized to explain the way restricting access to means may operate to prevent suicide. Firstly, in those cases of impulsive suicidal behavior where the intent to die is not strong, increasing the difficulty of obtaining the means for suicide may give individuals greater opportunity to think through their options and may therefore reduce the likelihood that they will follow through with the suicidal act. Secondly, where the intent to die is stronger but the suicidal behavior is still impulsive, postponing the act by making it harder to obtain the necessary means will afford a greater opportunity for other preventive interventions to take place. Finally, irrespective of impulsivity or intent, reducing the lethality of means available may result in lower rates of case fatality (i.e., although the rate of suicide attempts may remain the same or may even increase, the rate of completed suicides may come down).

It is also important to note that, among parents whose children visited an emergency department for a mental health assessment or treatment, those who received injury prevention education from hospital staff are significantly more likely to limit access to lethal means of self-harm than are families who did not receive such education.

Implementation Considerations

The safety of our young people is a serious concern to all. Messages on restricting access to means of suicide should be crafted collaboratively to achieve community-wide support. Public education campaigns aimed at preventing youth suicide should incorporate messages on reducing access to lethal means of self harm as well.

Sample Implementation Activities

Select and/or create media to educate the public about the role of trains in youth suicide as well as the role of all other lethal means.

Conduct a public information campaign(s) designed to reduce the accessibility of lethal means of self harm in the home and including trains.

Solicit help from Caltrain to support campaigns for safe rails.

Conduct public forums for parents, guardians, and media on strategies for securing weapons and medications, particularly prescription drugs and those stored in large quantities.

Train professionals and other adults who provide services to youth at risk for suicide about train access issues.

Increase the proportion of primary care and other health care providers who routinely assess the presence of lethal means (including firearms, drugs, and poisons) in the home and educate patients about actions to reduce risks.